Asian women have attenuated sympathetic activation but enhanced renal-adrenal responses during pregnancy compared to Caucasian women

Yoshiyuki Okada, Stuart A. Best, Sara S Jarvis, Shigeki Shibata, Rosemary S. Parker, Brian M. Casey, Benjamin D. Levine, Qi Fu

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Key points: Asian women have a lower prevalence of hypertensive disorders of pregnancy than Caucasian women. This is the first longitudinal study to investigate neural and humoral responses during pregnancy in Asians and Caucasians. The key finding was that Asians had attenuated sympathetic activation but enhanced renal-adrenal responsiveness during pregnancy compared to Caucasians. These results may provide insights into the pathophysiological mechanisms for racial differences in the prevalence of hypertensive disorders during pregnancy. Asians have a lower prevalence of hypertensive disorders of pregnancy than Caucasians. Since sympathetic overactivity and dysregulation of the renal-adrenal system (e.g. low aldosterone levels) have been found in preeclamptic women, we hypothesized that Asians have lower muscle sympathetic nerve activity (MSNA) and greater aldosterone concentrations during normal pregnancy than Caucasians. In a prospective study, blood pressure (BP), heart rate (HR), and MSNA were measured during supine and upright tilt (30 deg and 60 deg for 5 min each) in 9 Asians (32 ± 1 years (mean ± SEM)) and 12 Caucasians (29 ± 1 years) during pre-, early (≤8 weeks of gestation) and late (32-36 weeks) pregnancy, and post-partum (6-10 weeks after delivery). Supine MSNA increased with pregnancy in both groups (P < 0.001); it was significantly lower in Asians than Caucasians (14 ± 3 vs. 23 ± 3 bursts min-1 and 16 ± 5 vs. 30 ± 3 bursts min-1 in early and late pregnancy, respectively; P = 0.023). BP decreased during early pregnancy (P < 0.001), but was restored during late pregnancy. HR increased during pregnancy (P < 0.001) with no racial difference (P = 0.758). MSNA increased during tilting and it was markedly lower in Asians than Caucasians in late pregnancy (31 ± 6 vs. 49 ± 3 bursts min-1 at 60 deg tilt; P = 0.003). Upright BP was lower in Asians, even in pre-pregnancy (P = 0.006), and this racial difference persisted during pregnancy. Direct renin and aldosterone increased during pregnancy (both P < 0.001); these hormones were greater in Asians (P = 0.086 and P = 0.014). Thus, Asians have less sympathetic activation but more upregulated renal-adrenal responses than Caucasians during pregnancy. These results may explain, at least in part, why Asian women are at low risk of hypertensive disorders in pregnancy.

Original languageEnglish (US)
Pages (from-to)1159-1168
Number of pages10
JournalJournal of Physiology
Volume593
Issue number5
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Fingerprint

Kidney
Pregnancy
Aldosterone
Blood Pressure
Muscles
Heart Rate
Renin
Longitudinal Studies
Myocardium
Hormones
Prospective Studies

ASJC Scopus subject areas

  • Physiology

Cite this

Asian women have attenuated sympathetic activation but enhanced renal-adrenal responses during pregnancy compared to Caucasian women. / Okada, Yoshiyuki; Best, Stuart A.; Jarvis, Sara S; Shibata, Shigeki; Parker, Rosemary S.; Casey, Brian M.; Levine, Benjamin D.; Fu, Qi.

In: Journal of Physiology, Vol. 593, No. 5, 01.03.2015, p. 1159-1168.

Research output: Contribution to journalArticle

Okada, Yoshiyuki ; Best, Stuart A. ; Jarvis, Sara S ; Shibata, Shigeki ; Parker, Rosemary S. ; Casey, Brian M. ; Levine, Benjamin D. ; Fu, Qi. / Asian women have attenuated sympathetic activation but enhanced renal-adrenal responses during pregnancy compared to Caucasian women. In: Journal of Physiology. 2015 ; Vol. 593, No. 5. pp. 1159-1168.
@article{273055ff1daa45c28e6437640b6c4f8c,
title = "Asian women have attenuated sympathetic activation but enhanced renal-adrenal responses during pregnancy compared to Caucasian women",
abstract = "Key points: Asian women have a lower prevalence of hypertensive disorders of pregnancy than Caucasian women. This is the first longitudinal study to investigate neural and humoral responses during pregnancy in Asians and Caucasians. The key finding was that Asians had attenuated sympathetic activation but enhanced renal-adrenal responsiveness during pregnancy compared to Caucasians. These results may provide insights into the pathophysiological mechanisms for racial differences in the prevalence of hypertensive disorders during pregnancy. Asians have a lower prevalence of hypertensive disorders of pregnancy than Caucasians. Since sympathetic overactivity and dysregulation of the renal-adrenal system (e.g. low aldosterone levels) have been found in preeclamptic women, we hypothesized that Asians have lower muscle sympathetic nerve activity (MSNA) and greater aldosterone concentrations during normal pregnancy than Caucasians. In a prospective study, blood pressure (BP), heart rate (HR), and MSNA were measured during supine and upright tilt (30 deg and 60 deg for 5 min each) in 9 Asians (32 ± 1 years (mean ± SEM)) and 12 Caucasians (29 ± 1 years) during pre-, early (≤8 weeks of gestation) and late (32-36 weeks) pregnancy, and post-partum (6-10 weeks after delivery). Supine MSNA increased with pregnancy in both groups (P < 0.001); it was significantly lower in Asians than Caucasians (14 ± 3 vs. 23 ± 3 bursts min-1 and 16 ± 5 vs. 30 ± 3 bursts min-1 in early and late pregnancy, respectively; P = 0.023). BP decreased during early pregnancy (P < 0.001), but was restored during late pregnancy. HR increased during pregnancy (P < 0.001) with no racial difference (P = 0.758). MSNA increased during tilting and it was markedly lower in Asians than Caucasians in late pregnancy (31 ± 6 vs. 49 ± 3 bursts min-1 at 60 deg tilt; P = 0.003). Upright BP was lower in Asians, even in pre-pregnancy (P = 0.006), and this racial difference persisted during pregnancy. Direct renin and aldosterone increased during pregnancy (both P < 0.001); these hormones were greater in Asians (P = 0.086 and P = 0.014). Thus, Asians have less sympathetic activation but more upregulated renal-adrenal responses than Caucasians during pregnancy. These results may explain, at least in part, why Asian women are at low risk of hypertensive disorders in pregnancy.",
author = "Yoshiyuki Okada and Best, {Stuart A.} and Jarvis, {Sara S} and Shigeki Shibata and Parker, {Rosemary S.} and Casey, {Brian M.} and Levine, {Benjamin D.} and Qi Fu",
year = "2015",
month = "3",
day = "1",
doi = "10.1113/jphysiol.2014.282277",
language = "English (US)",
volume = "593",
pages = "1159--1168",
journal = "Journal of Physiology",
issn = "0022-3751",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Asian women have attenuated sympathetic activation but enhanced renal-adrenal responses during pregnancy compared to Caucasian women

AU - Okada, Yoshiyuki

AU - Best, Stuart A.

AU - Jarvis, Sara S

AU - Shibata, Shigeki

AU - Parker, Rosemary S.

AU - Casey, Brian M.

AU - Levine, Benjamin D.

AU - Fu, Qi

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Key points: Asian women have a lower prevalence of hypertensive disorders of pregnancy than Caucasian women. This is the first longitudinal study to investigate neural and humoral responses during pregnancy in Asians and Caucasians. The key finding was that Asians had attenuated sympathetic activation but enhanced renal-adrenal responsiveness during pregnancy compared to Caucasians. These results may provide insights into the pathophysiological mechanisms for racial differences in the prevalence of hypertensive disorders during pregnancy. Asians have a lower prevalence of hypertensive disorders of pregnancy than Caucasians. Since sympathetic overactivity and dysregulation of the renal-adrenal system (e.g. low aldosterone levels) have been found in preeclamptic women, we hypothesized that Asians have lower muscle sympathetic nerve activity (MSNA) and greater aldosterone concentrations during normal pregnancy than Caucasians. In a prospective study, blood pressure (BP), heart rate (HR), and MSNA were measured during supine and upright tilt (30 deg and 60 deg for 5 min each) in 9 Asians (32 ± 1 years (mean ± SEM)) and 12 Caucasians (29 ± 1 years) during pre-, early (≤8 weeks of gestation) and late (32-36 weeks) pregnancy, and post-partum (6-10 weeks after delivery). Supine MSNA increased with pregnancy in both groups (P < 0.001); it was significantly lower in Asians than Caucasians (14 ± 3 vs. 23 ± 3 bursts min-1 and 16 ± 5 vs. 30 ± 3 bursts min-1 in early and late pregnancy, respectively; P = 0.023). BP decreased during early pregnancy (P < 0.001), but was restored during late pregnancy. HR increased during pregnancy (P < 0.001) with no racial difference (P = 0.758). MSNA increased during tilting and it was markedly lower in Asians than Caucasians in late pregnancy (31 ± 6 vs. 49 ± 3 bursts min-1 at 60 deg tilt; P = 0.003). Upright BP was lower in Asians, even in pre-pregnancy (P = 0.006), and this racial difference persisted during pregnancy. Direct renin and aldosterone increased during pregnancy (both P < 0.001); these hormones were greater in Asians (P = 0.086 and P = 0.014). Thus, Asians have less sympathetic activation but more upregulated renal-adrenal responses than Caucasians during pregnancy. These results may explain, at least in part, why Asian women are at low risk of hypertensive disorders in pregnancy.

AB - Key points: Asian women have a lower prevalence of hypertensive disorders of pregnancy than Caucasian women. This is the first longitudinal study to investigate neural and humoral responses during pregnancy in Asians and Caucasians. The key finding was that Asians had attenuated sympathetic activation but enhanced renal-adrenal responsiveness during pregnancy compared to Caucasians. These results may provide insights into the pathophysiological mechanisms for racial differences in the prevalence of hypertensive disorders during pregnancy. Asians have a lower prevalence of hypertensive disorders of pregnancy than Caucasians. Since sympathetic overactivity and dysregulation of the renal-adrenal system (e.g. low aldosterone levels) have been found in preeclamptic women, we hypothesized that Asians have lower muscle sympathetic nerve activity (MSNA) and greater aldosterone concentrations during normal pregnancy than Caucasians. In a prospective study, blood pressure (BP), heart rate (HR), and MSNA were measured during supine and upright tilt (30 deg and 60 deg for 5 min each) in 9 Asians (32 ± 1 years (mean ± SEM)) and 12 Caucasians (29 ± 1 years) during pre-, early (≤8 weeks of gestation) and late (32-36 weeks) pregnancy, and post-partum (6-10 weeks after delivery). Supine MSNA increased with pregnancy in both groups (P < 0.001); it was significantly lower in Asians than Caucasians (14 ± 3 vs. 23 ± 3 bursts min-1 and 16 ± 5 vs. 30 ± 3 bursts min-1 in early and late pregnancy, respectively; P = 0.023). BP decreased during early pregnancy (P < 0.001), but was restored during late pregnancy. HR increased during pregnancy (P < 0.001) with no racial difference (P = 0.758). MSNA increased during tilting and it was markedly lower in Asians than Caucasians in late pregnancy (31 ± 6 vs. 49 ± 3 bursts min-1 at 60 deg tilt; P = 0.003). Upright BP was lower in Asians, even in pre-pregnancy (P = 0.006), and this racial difference persisted during pregnancy. Direct renin and aldosterone increased during pregnancy (both P < 0.001); these hormones were greater in Asians (P = 0.086 and P = 0.014). Thus, Asians have less sympathetic activation but more upregulated renal-adrenal responses than Caucasians during pregnancy. These results may explain, at least in part, why Asian women are at low risk of hypertensive disorders in pregnancy.

UR - http://www.scopus.com/inward/record.url?scp=84923586974&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923586974&partnerID=8YFLogxK

U2 - 10.1113/jphysiol.2014.282277

DO - 10.1113/jphysiol.2014.282277

M3 - Article

VL - 593

SP - 1159

EP - 1168

JO - Journal of Physiology

JF - Journal of Physiology

SN - 0022-3751

IS - 5

ER -